Cardiac resynchronisation therapy in populations underrepresented in randomised controlled trials

摘要

CRT is an effective treatment for heart failure patients who meet the inclusion criteria of the main RCTs. Current estimations indicate that around 400 patients/million population/year might be candidates for CRT. However, the number of CRT units implanted in 2011 were 140 units/ million population/year (data from 16 European countries). Therefore, there is still a significant margin for improvement in the treatment of heart failure patients. Whether older age, non-LBBB QRS morphology or the presence of associated comorbidities such as renal dysfunction or diabetes contribute to the low use of this guideline recommended therapy remains unclear. Dedicated RCTs in these subpopulations are needed to further determine which patients may benefit from CRT.